Innovative virtual reality treadmill therapy offers relief for treatment-resistant PTSD

A study involving Canadian military veterans, public safety personnel, and healthcare workers showed that their PTSD, depression, and anxiety symptoms decreased after 10 to 14 weeks of 3MDR therapy. Their difficulties with life functioning were also reduced. The improvements were still present 12 months after the treatments ended. The paper was published in Brain and Behavior.

Multimodal Motion-Assisted Memory Desensitization and Reconsolidation (3MDR) is an innovative psychotherapy developed for people suffering from post-traumatic stress disorder (PTSD), particularly those who have not responded sufficiently to conventional trauma-focused treatments. It combines established principles of exposure therapy (a psychological treatment that helps people safely confront traumatic memories) and eye movement desensitization and reprocessing (EMDR) with walking and an immersive virtual environment.

During treatment, patients walk on a treadmill toward personally selected images related to their traumatic experiences, while music and other cues are used to help evoke relevant memories and emotions. With the therapist’s guidance, patients describe the memories, thoughts, feelings, and bodily reactions that emerge rather than avoiding distressing traumatic material. An attention task involving eye movements is then used while the traumatic memory is active, with the aim of facilitating further processing and reducing its emotional intensity. The combination of movement, immersive stimulation, exposure, and memory-processing techniques is intended to make it easier for patients to approach memories that they might otherwise strongly avoid.

3MDR was initially developed for military personnel and veterans with combat-related and treatment-resistant PTSD (defined as having tried two or more previous therapies without success) but has subsequently been studied in other groups exposed to severe trauma. Overall, 3MDR represents a promising new approach for treating PTSD, especially in cases where avoidance or limited response to conventional therapy makes treatment particularly difficult.

Study co-first authors Matthew Robert Graham Brown and Phillip R. Sevigny, along with their colleagues, conducted a study in which they examined the effectiveness of 3MDR in Canadian military veterans. They also wanted to test it with public safety personnel (police, firefighters, paramedics, etc.) and frontline healthcare workers. Their general hypothesis was that 3MDR treatment would lead to improvements in mental health symptoms of participants and that the improvements would still be present a year after treatment.

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Study participants were initially 56 Canadian military members and Veterans, public safety personnel, and healthcare workers. However, eight participants were excluded from the analysis for various reasons, making the total number of study participants 48. Twenty-four participants were women. Their average age was 45.4 years. Seventeen participants were Canadian military veterans or active members of the military, 21 were public safety personnel, and 21 were healthcare workers. All of them exhibited clinically relevant symptoms of PTSD. Twenty-two of them met criteria for treatment-resistant PTSD, and this included all 17 military members and Veterans.

Participants received 3MDR therapy at the Edmonton Operational Stress Injury Clinic (EOSIC), which partnered with the research team for this study, or at one of three clinical research sites: University of Alberta main campus in Edmonton, Alberta; Alberta Hospital Edmonton; or University of Alberta space rented at the University of Calgary’s downtown campus in Calgary, Alberta. The 3MDR treatment lasted 10 to 14 weeks.

At the start of the study and at the end of the treatment program, participants completed the CAPS-5 clinical interview (an assessment of PTSD symptoms). A smaller group of 30 participants who were available for the follow-up also completed it 3, 6, and 12 months after the end of the treatment. At the start of the study and after specific sessions during the treatment, participants also completed assessments of depression, anxiety, and difficulties with life functioning. Participants completed an assessment of resilience before the 3MDR treatment and after it was complete.

Results showed that participants’ PTSD symptoms, depression, anxiety, and difficulties with life functioning improved after the 3MDR treatment. These improvements were still present 12 months after the treatment ended. Resilience also showed improvement from before to after the treatment.

“These results support the growing body of literature illustrating 3MDR as an effective treatment for military-related PTSD as well as PTSD-related mental health conditions in public safety personnel and healthcare workers,” the study authors concluded.

The study sheds light on the effectiveness of 3MDR therapy as a treatment for PTSD. However, the study did not include a control group, although the study authors anticipated a natural waitlist control group to form due to expected scheduling delays, which ultimately did not occur. Because of this, it remains unclear how much of the reported improvements are a consequence of the treatment and how much can be attributed to natural reductions in symptoms over time or factors not related to the 3MDR treatment.

The paper, “3MDR Therapy Reduces Symptoms of PTSD and Related Conditions in Canadian Military Members and Veterans, Public Safety Personnel, and Clinical Personnel,” was authored by Matthew Robert Graham Brown, Phillip R. Sevigny, Katherine S. Bright, Helen Chau, Patricia Chai, Andrew J. Greenshaw, Lisa Burback, Olga Winkler, Chelsea Jones, and Suzette Brémault-Phillips.